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Determinants of long-term mortality in patients with type B acute aortic dissection

Kenichi Sakakura1, Norifumi Kubo, Junya Ako

  • 1Division of Cardiovascular Medicine, Department of Integrated Medicine I, Jichi Medical University Saitama Medical Center, Saitama, Japan.

American Journal of Hypertension
|February 7, 2009
PubMed

Insights

Long-term survival in Type B acute aortic dissection (AAD) is improved with calcium channel blockers (CCBs). Impaired renal function predicts adverse outcomes in AAD patients, while CCBs are associated with increased survival.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Nephrology

Background:

  • Type B acute aortic dissection (AAD) has high short- and midterm mortality.
  • Long-term outcomes and predictors for Type B AAD are not well understood.
  • Identifying long-term prognostic factors, including antihypertensive medications, is crucial.

Purpose of the Study:

  • To identify long-term predictors of mortality in Type B AAD patients.
  • To investigate the role of antihypertensive medications in long-term survival after Type B AAD.

Main Methods:

  • A clinical follow-up study was conducted on 202 patients with Type B AAD.
  • Univariate and multivariate Cox regression analyses were used to determine mortality predictors.

Main Results:

  • Impaired renal function and older age were significant predictors of mortality.
  • Calcium channel blockers (CCBs), beta-blockers, and ACE inhibitors were associated with increased survival.
  • Multivariate analysis confirmed CCBs as a significant predictor of increased survival (HR 0.38, P=0.04) and impaired renal function as a predictor of death (HR 3.41, P=0.002).
  • Patients discharged without antihypertensive medication had significantly higher mortality (HR 9.51, P=0.007).

Conclusions:

  • Impaired renal function is a predictor of adverse outcomes in Type B AAD.
  • Discharge with CCBs is associated with improved long-term survival in Type B AAD patients.
Abstract

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